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Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens

Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens

Macharia, Peter, Joseph, Noel, Nalwadda, Gorrette K, Mwilike, Beatrice, Banke-Thomas, Aduragbemi ORCID: 0000-0002-4449-0131 , Benova, Lenka and Johnson, Olatunji (2022) Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens. BMC Pregnancy and Childbirth, 22:908. pp. 1-16. ISSN 1471-2393 (Online) (doi:https://doi.org/10.1186/s12884-022-05238-1)

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Abstract

Pregnant women in sub-Saharan Africa (SSA) experience the highest levels of maternal mortality and stillbirths due to predominantly avoidable causes. Antenatal care (ANC) can prevent, detect, alleviate, or manage these causes. While eight ANC contacts are now recommended, coverage of the previous minimum of four visits (ANC4+) remains low and inequitable in SSA. We modelled ANC4+ coverage and likelihood of attaining district-level target coverage of 70% across three equity stratifiers (household wealth, maternal education, and travel time to the nearest health facility) based on data from malaria indicator surveys in Kenya (2020), Uganda (2018/19) and Tanzania (2017). Geostatistical models were fitted to predict ANC4+ coverage and compute exceedance probability for target coverage. The number of pregnant women without ANC4+ were computed. Prediction was at 3 km spatial resolution and aggregated at national and district -level for sub-national planning. About six in ten women reported ANC4+ visits, meaning that approximately 3 million women in the three countries had  20,000 women having

Item Type: Article
Uncontrolled Keywords: Antenatal care, Inequities, Household wealth, Maternal education, travel time to healthcare; model‐based geostatistics; subnational; district; Kenya; Uganda; Tanzania
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > RA Public aspects of medicine
R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families
Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified: 14 Dec 2022 11:56
URI: http://gala.gre.ac.uk/id/eprint/38265

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